Organizational Culture and Quality of Life in Nursing Homes: A Qualitative Study

疗养院的组织文化和生活质量：定性研究

• 批准号: 7083209
• 负责人: Miriam Ryvicker
• 金额: $ 3.18万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-01 至 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7083209
• 关键词: administrative personnel; behavioral /social science research tag; caregivers; clinical research; conflict; culture; emotional dependency; ethics; health care personnel performance; health care policy; human subject; nursing administration; nursing care evaluation; nursing care quality; nursing homes; nursing personnel; outcomes research; patient care personnel attitude; patient care personnel relations; predoctoral investigator; quality of life; racial /ethnic difference; social support network

DESCRIPTION (provided by the applicant): This dissertation examines the effects of organizational culture on quality of life in two nursing homes. Previous ethnographic studies of nursing homes suggest that the bureaucratic regulations meant to improve quality of care lead to an emphasis on organizational efficiency that conflicts with an ethic of caring. This dissertation re-examines this idea by analyzing how different organizational cultures surrounding bureaucratic regulation affect caregivers' abilities to customize care to residents' individual needs. I conduct ethnographic research in two well-regarded nursing homes that are similar in structural characteristics, but vary in organizational culture, particularly in their approaches to bureaucratic procedure. Therefore, this study asks: How do different organizational cultures shape the formation of a caring environment in nursing homes? Previous assessments of quality of life in nursing homes have used brief observation as a source of data, alongside patient surveys. The comparative ethnographic design of the proposed project deepens the analysis of quality of life by providing a detailed, long-term account of the organizational processes that produce different outcomes in quality of life surveys. Ethnography allows me to examine how caregiving relationships change over time in response to their surrounding circumstances. Out of this approach I develop analytic categories for assessing the degree to which caregivers attend to the emotional needs of residents. The long-term goal of this study is to develop tools for analyzing the effects of different organizational structures and cultures on quality of life in nursing homes and other long-term care facilities. As emphasized in the goals of the Agency for Healthcare Research and Quality, organizational efficiency is a necessary aim for improving overall quality of care in health care facilities such as nursing homes. This study seeks to improve our understanding of how health care organizations can maintain a certain level of efficiency, while promoting practices that respond to patients' social, emotional, and spiritual needs. Therefore, this dissertation advances AHRQ's interests in developing measures of health care quality, improving efficiency in health services, and promoting a patient-centered approach to care.

描述（由申请人提供）：本文探讨了组织文化对两个养老院的生活质量的影响。以前的民族志研究养老院表明，官僚的规定，旨在提高护理质量导致强调组织效率，与伦理的关怀冲突。本文通过分析不同的组织文化如何影响照顾者的能力，以定制照顾居民的个人需求，官僚监管重新审视这一想法。我在两个备受推崇的养老院进行人种学研究，这两个养老院在结构特征上相似，但在组织文化上有所不同，特别是在官僚程序方面。因此，本研究问：不同的组织文化如何塑造形成一个照顾环境，在养老院？以前对疗养院生活质量的评估都是使用简短的观察作为数据来源， 以及患者调查拟议项目的比较民族志设计深化了 通过提供详细的，长期的组织过程来分析生活质量， 在生活质量调查中产生不同的结果。人种学让我可以研究 随着时间的推移，关系会随着周围环境的变化而变化。基于这种方法，我 发展分析类别，以评估照顾者照顾居民情感需求的程度。这项研究的长期目标是开发工具，用于分析不同的 组织结构和文化对养老院和其他长期护理设施的生活质量的影响。正如医疗保健研究和质量机构的目标所强调的那样，组织效率是提高疗养院等医疗保健设施整体护理质量的必要目标。这项研究旨在提高我们对医疗机构如何保持一定水平的效率的理解，同时促进对患者的社会，情感和精神需求做出反应的做法。因此，本论文提出AHRQ的利益，制定措施的卫生保健质量，提高效率的卫生服务，并促进以病人为中心的方法来照顾。